Prone Position for Acute Respiratory Distress Syndrome. A Systematic Review and Meta‐Analysis

@article{Munshi2017PronePF,
  title={Prone Position for Acute Respiratory Distress Syndrome. A Systematic Review and Meta‐Analysis},
  author={Laveena Munshi and Lorenzo Del Sorbo and Neill K. J. Adhikari and Carol L. Hodgson and Hannah Wunsch and Maureen O. Meade and Elizabeth Uleryk and Jordi Mancebo and Antonio Pesenti and Marco Vito Ranieri and Eddy Fan},
  journal={Annals of the American Thoracic Society},
  year={2017},
  volume={14},
  pages={S280–S288}
}
Rationale: The application of prone positioning for acute respiratory distress syndrome (ARDS) has evolved, with recent trials focusing on patients with more severe ARDS, and applying prone ventilation for more prolonged periods. Objectives: This review evaluates the effect of prone positioning on 28‐day mortality (primary outcome) compared with conventional mechanical ventilation in the supine position for adults with ARDS. Methods: We updated the literature search from a systematic review… 

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References

SHOWING 1-10 OF 32 REFERENCES

Prone positioning reduces mortality from acute respiratory distress syndrome in the low tidal volume era: a meta-analysis

Prone positioning is associated with significantly reduced mortality from ARDS in the low tidal volume era and substantial heterogeneity across studies can be explained by differences in tidal volume.

The Efficacy and Safety of Prone Positional Ventilation in Acute Respiratory Distress Syndrome: Updated Study-Level Meta-Analysis of 11 Randomized Controlled Trials*

Ventilation in the prone position significantly reduced overall mortality in patients with severe acute respiratory distress syndrome andufficient duration of prone positioning was significantly associated with a reduction in overall mortality.

Prone positioning in patients with moderate and severe acute respiratory distress syndrome: a randomized controlled trial.

Data from this study indicate that prone positioning does not provide significant survival benefit in patients with ARDS or in subgroups of patients with moderate and severe hypoxemia.

An updated study-level meta-analysis of randomised controlled trials on proning in ARDS and acute lung injury

Long duration of ventilation in prone position significantly reduces ICU mortality when only ARDS patients are considered, and prone positioning was not associated with a statistical increase in major airway complications.

A multicenter trial of prolonged prone ventilation in severe acute respiratory distress syndrome.

Pone ventilation is feasible and safe, and may reduce mortality in patients with severe ARDS when it is initiated early and applied for most of the day.

Prone positioning in acute respiratory distress syndrome: a multicenter randomized clinical trial

Data added to this study adds data that reinforce the suggestion of a beneficial effect of early continuous prone positioning on survival in ARDS patients, and helps clarify the role of protective ventilation in the treatment of prone patients.

Effects of systematic prone positioning in hypoxemic acute respiratory failure: a randomized controlled trial.

This trial demonstrated no beneficial outcomes and some safety concerns associated with prone positioning, but for patients with hypoxemic ARF, prone position placement may lower the incidence of VAP.

Prone positioning improves oxygenation in post-traumatic lung injury--a prospective randomized trial.

Intermittent prone positioning was not able to reduce the duration of mechanical ventilation in this limited number of patients, however the oxygenation improved significantly over the first four days of treatment, and the prevalence of ARDS and pneumonia were reduced.

Comparison of prone positioning and high-frequency oscillatory ventilation in patients with acute respiratory distress syndrome*

Although HFOV in the supine position does not improve oxygenation or lung inflammation, the prone position increases oxygenation and reduces lung inflammation in ARDS patients.

Effects of prone position on inflammatory markers in patients with ARDS due to community-acquired pneumonia.